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Pharmacology > Exam 2 Study Guide- Cardiovascular > Flashcards

Exam 2 Study Guide- Cardiovascular Flashcards

1
Q

What is the prototype for statin medications (HMG- CoA Reductase Inhibitors)?

A

atorvastatin (Lipitor)

**all statin medications end in “statin”

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2
Q

atorvastin (Lipitor)

  • mechanism of action
  • adverse effects
  • interactios
  • major nursing assessments
A
  • moa: inhibits HMG-CoA reductase and cholesterol synthesis in the liver; can decrease LDL’s up to 20-40% and can decrease trigly.
  • adverse effects: liver function, rhabdomyolysis (breakdown of muscle fibers)->can cause renal failure, headache and fatigue
  • interactions: grapefruit juice, Digoxin, Erythromycin
  • major assessments: monitor protein levels, kidney & liver function, monitor for muscle pain and/or weakness (signs of rhabdomyolysis)
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3
Q

What is the prototype for bile acid-binding resins?

A

cholestyramine (Questran)

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4
Q

What is the first line of choice to reduce lipid levels?

A

Statin Medications

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5
Q

cholestyramine (Questran)

  • mechanism of action
  • adverse effects
  • interactions
A
  • moa: Increases excretion of cholesterol in the stool
  • adverse effects: GI upset, decreased levels of Vitamin K (can increase the effects of anticoagulants)
  • interactions: Digoxin and thiazide diuretics
  • can produce a 20% decrease in LDL levels
  • comes in powder form-needs to be diluted in h2o and pt need to drink a lot of h2o
  • no medications can be taken 2 hours before or 4 hours after (a lot of interactions)
  • usually used in conjunction with statin medications
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6
Q

Niacin

  • moa
  • adverse effects
A
  • moa: decreases both VLDL and LDL levels
  • adverse effects: hot flashes, flushing, hepatotoxicity (need to monitor liver function)
  • given in low doses
  • can predispose pt to Gout (can see an increase in uric acid)
  • can cause blood sugar elevation (monitor blood glucose levels)
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7
Q

What is the prototype for Cholesterol Absorption Inhibitors?

A

Zetia

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8
Q

Zetia

  • mechanism of action
  • adverse effects
A
  • moa: inhibits the absorption of cholesterol
  • adverse effects: upper respiratory issues (cold, cough), myalgia **no serious side effects

*usually used in combo w/ statin

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9
Q

Nonpharmacolgic Management of HTN (8)

A
  • limit alcohol intake
  • restrict sodium intake
  • reduce intake of saturated fat and cholesterol
  • increase fresh fruits & veggies
  • increase aerobic physical activity
  • discontinue tobacco use
  • reduce stress
  • maintain optimum weight
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10
Q

What are the 3 different types of diuretics? (and their prototype)

A
  1. Loop Diuretics (Lasix & Bumex)
  2. Thiazide Diuretics (HCTZ)
  3. Potassium-Sparing Diuretics (Aldactone)
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11
Q

furosemide (Lasix) & bumetanide (Bumex)

  • huge loss of what electrolyte?
  • adverse effects
A
  • huge potassium loss (hypokalemia): leg cramps, muscle weakness, shallow/labored breathing, dysrhythmias
  • adverse effects: orthostatic HTN (due to huge fluid shift), ototoxicity (when pushed too fast)
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12
Q

HCTZ (Microzide)

-mechanism of action

A
  • moa: depletes the body of potassium (not as sever as loop diuretic)
  • Hyperkalemia can ^ Digoxin toxicity
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13
Q

spironolctone (Aldactone)

  • patient teaching
  • contraindication
A
  • patient teaching: limit the use of salt substitutes and potassium rich foods
  • contra: never use with pt’s w/ renal failure
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14
Q

What is the prototype for calcium channel blockers?

A

nifedipine (Procardia)

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15
Q

nifedipine (Procardia)

  • use
  • mechanism of action
  • adverse effects
  • interactions
A
  • use: Treat HTN and angina
  • moa: block calcium ion channel in arterial smooth muscle, causing vasodilation (causes BP to decrease, and can be significant)
  • adverse effects: hyptension
  • interactions: grapefuit juice

*Al calcium channel blocker medications end in “pine”

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16
Q

What is the prototype for ACE inhibitors?

A

lisinopril (Prinvil)

*All ACE inhibitors end in “pril”

17
Q

lisinopril (Prinvil)

  • mechanism of action
  • adverse effects
A

-moa: block formation of angiotensin II causing vasodilation and block aldosterone secretion causing decreased fluid volume
adverse effects: cough, angioedema (swelling of airways), hyperkalemia

18
Q

All Beta-adrenergic blockers end in -_____ and all Angiotensin II receptor blockers end in -________.

A

“lol”; “sartan”

*Angiotension II blockers are used for patients that can’t tolerate ACE inhibitors

19
Q

Beta-adrenegic blockers

  • mechanism of action
  • adverse effects
A
  • moa: decrease the heart rate and myocardial contractility
  • adverse effects: bradycardia, fluid retention, fatigue
  • have to be tapered down due to risk of rebound HTN
  • not 1st choice of drug for treatment of HTN
20
Q

What is the prototype for Alpha-adrenergic blockers?

A

doxazosin (Cardura)

21
Q

doxazosin (Cardura)

-mechanism of action

A
  • moa: inhibits sympasthetic actiavtes in the arterioles, causing vasodilation
  • not 1st choice of drug for HTN; usually used in combo w/ another drug
22
Q

What are the only two approved beta-blockers for treating heart failure?

A
  1. carvedilol (Coreg)

2. metoprolol (Toprol-XL)

23
Q

digoxin (Lanoxin)

  • mechanism of action
  • therapeutic level
  • adverse effects
  • interactions
  • S/S of toxicity
A
  • moa: increases contractility and lowers heart rate
  • therapeutic level: 0.8-2 ng/mL (anything ^1.8, hold & call dr)
  • adverse effects: bradycardia (hold if HR <60), hyperkalemia (Digoxin levels inverse to potassium), renal issues (excreted through the kidneys)
  • interactions: Diuretics, ACE inhibitors (can affect potassium levels), Ginseng (may increase toxicity)
  • S/S: yellow-green halos, blurred vision, GI upset (N/V)
24
Q

What medications are used for heart failure? (5)

A
  1. ACE Inhibitors (Prinivil)
  2. Diuretics
  3. Beta blockers
  4. Angiotensin II Receptor blockers
  5. Cardiac Glycoside (Digoxin)
25
Q

Nitroglycerin

  • mechanism of action
  • side effects
  • drug interactions
A
  • moa: causes vasodilation in both arterial and venous smooth muscle
  • side effects: headache
  • drug interactions: Viagra
26
Q

What 3 medications are used for angina?

A
  1. Nitrates
  2. Beta-blockers (decrease workload & contract.)
  3. Calcium Channel Blockers (decrease workload & contract.)
27
Q

Retavase

  • use
  • adverse effects
  • drug interactions
A
  • use: dissolve a blood clot (usually works w/ 20 mins)
  • adverse effects: hemorrhage
  • drug interactions: Any med that alters the blood coagulation (NSAID’s, Aspirin, anticoagulants-Coumadin)

Pharmacology (5 decks)

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